Who Will End Up Treating Fibromyalgia?
It makes some sense - rheumatologists specialize in joints, bones and muscles. They're not experts on how the brain perceives and processes pain. Neurologists are.
But will neurology welcome us with open arms? Are neurologists thinking how nice it would be to take on the challenge of fibromyalgia? Will their waiting lists accommodate a huge influx of people?
Many of us have had bad luck with GPs or internists. Do you suppose they're busily educating themselves so they can diagnose and treat us effectively?
Call me a cynic, but I'd say, not likely. Are we going to get stuck with primary care providers who don't even believe we're sick? Are we going to end up without a "home" as the medical community takes us out of the rheumatologic category without providing a viable alternative? What's your opinion?
I'd love to hear from those of you who already see a neurologist. How has your experience been? Do you think you're treated more effectively? Post your comments here or in About.com's Fibromyalgia & ME/CFS forum.
Comments
I have not been to a neurologist for my fibro…but I do believe it to be more a CNS disorder than rheumatological. Personally, I don’t believe that neurologist will welcome the multitudes of fibromites, while they would love the income. There isn’t much that they can do, other than treat it with the same drugs we receive from our GP’s or rheumatologists. I’m cynical too. It’s a shame when someone who is ill has to present a load of paperwork proving they have fibro…just so they will be validated in the medical community.
Maybe it’s because I live in a rural area and have to travel 42 miles one way to see a specialist, but my general internist has educated himself on FM and is treating me very well. I imagine this might not be the case in large cities, especially those with medical schools, where FM secialists actually exist.
But as it stands now, thank G-D for Dr. Tom.
My wonderful neurologist was frustrated by my FM and sent me to a wonderful rheumatologist. She has helped me, but now
isn’t seeing any more FM patients. She is willing to continue to treat me, but is also frustrated. I’ve received better results from
a combination of chiropractic, acupuncture, integrated manual therapy, Reiki, holistic treatments, and supplements than I ever did from pharmaceuticals and MD’s.
Having been to a neurologist and learning that what a bunch of doctors thought was FM turned out to be degenerative disk disease, I have a unique perspective on this question.
I think the answer lies in the doctor him or herself. Do they have the right attitude to want to listen, learn, and have the patience to treat.
It takes a variety of specialities to treat the symptoms that accompany Fibromyalgia as well as ME/CFS. The FMAware folks ( www.fmaware.org ) have done a good job with awareness and educating doctors.
I found that the Canadians have created a document - The Canadian Clinical Case Defintion for Fibromyalgia Syndrome. You can view this document at:
http://sacfs.asn.au/download/consensus_overview_fms.pdf
You can judge for yourself whether you think its something your particular doctor might be interested in reading and learning from. We know that some doctors just don’t want to cooperate. Its easier to push you off onto a therapist. Until they get their act together, we must be persistent in finding our own doctors. If they don’t do the job, fire them and move on.
Granny
I have always been of the opinion that fibro is a disorder that is rheumatologic and neurologic. However, I have not found either specialist to be particularly helpful. It is my GP who has been the most beneficial as medical support and in helping me to manage and control my pain and symptoms.
I believe that each individual with fibromyalgia is unique and has his/her own symptoms that react in their own unique way. Each person requires a specialized plan of care and treatment rather than one that is general and thought to cover all persons with fibro.
I have been unable to work or function at most any level for the past three years and I still find almost everyday that the severity, intensity, duration and type of symptoms vary making it a daily consideration on how to best manage/control the pain and symptoms.
Medical professionals/specialists can provide us with treatments and pharmaceuticals but I find that it is me who is the one managing my care and determing my treatment/care options for a specific day/time. I consider that they provide me with the tools and it is me who has to learn and determine how best to use them.
I think that the research I have seen from reputable sources seems to be pointing to a neurochemical basis for fibromyalgia but there still seems to be no real understanding of what causes it to start.
For five years, I was under the care of the internist who diagnosed my fibromyalgia and chronic migraines. I am covered by military retiree insurance. Suddenly, this last year, that doctor dropped, without notice, all of his patients covered by this insurance. I was on a narcotic that was not only not doing much for the pain but was causing some side effects. So, you can guess what I think of doctors in general, I was left to deal with narcotic withdrawal on my own.
I have found another primary care doc but he doesn’t treat fibro however, he did work hard at finding me a pain management doc who is a neurologist. I get the distinct impression the neuro thinks that my problems all evolve around depression and if he just keeps raising the antidepressant dose, I’ll eventually hurt less. Is there anyone out there who is in constant pain who is not depressed? they get the cart before the horse every time.
All docs push the SSRI or SSNRI drugs like they are a cure all. For me, they cause significant heart problems and I end up backing down on the dose.
Until they come up with a real cause/effect/treatment for fibro that works, CFS or whatever you want to call it…whatever doctor listens, believes the disorders are real, is willing to work with you AND who will take your insurance is the doctor to see.
For whatever it is worth.
Lois
Lois
linda you are so right - i have never heard treatment described that way - but it is so the truth - we are given the tools by whatever dr. is treating us and we must decide almost on a daily basis how we should respond to that treatment in order to make each day better
I think that a Psyiatrist (spelled wrong, but it is a Dr. of physyical medicine) should oversee FMS patients. Water exercise helps me the most and I tell my Primary what meds I need, etc. It’s like the Dr. gives me the tools to keep my pain under “some” control. I think the specific Dr./person is what makes the right FMS Dr., not any specific specialty!
any of you get severe “unexplained” eye pain?
Neurologists definitely need education as well! I was referred to a neurologist for possible early Alzheimer’s - his diagnosis was ARCD (Age Related Cognitive Decline). At the end of the appointment I asked him about Fibromyalgia as I understood that it is treated by neurologists. He said no, that psychiatrists, not neurologists, treat fibromyalgia. Fortunately, I found treatment at a FMS/CFS Clinic at a nearby large hospital.